Sunday, September 14, 2008

Accidental Exercise, Reversal of Flexion

One of the challenges of most working people is finding sufficient time to exercise. Because of the multiple obligations that most working people have (work itself, family, shopping, paying bills, keeping in touch with friends, etc), exercise is often the first thing that goes, usually with a pledge of "well, I'll fit it in later."

As one of my mentors in NJ used to say, later never comes.

One of the keys, then, is to find ways to sneak exercise into every day life.

One common strategy that has been discussed commonly is to find extra opportunities to walk. For example, you can park far from the entrance to your office, or make a point of using the stairs to work.

Another useful strategy is to turn seemingly mundane activities into exercise. I try not to endorse products, but I am going to make an exception for a book my friend and mentor, Joel Press, called the Couch Potato Workout.

http://www.amazon.com/Couch-Potato-Workout-Exercises-Home/dp/192998815X

In it, he describes some useful exercises that you can use while at home to get in a little bit of extra exercise. I don't want to steal his thunder (and I suppose his profits), but one of my favorites is to stand on one leg while brushing your teeth. This is a particularly effective exercise as the mini-perturbations from brushing stimulate the proprioceptive system to maintain balance at the hip and ankle. It sounds easy, but it's surprisingly challenging at first. Once you get good at it, try it with your eyes closed. For the super advanced toothbrush-exerciser, you can try it with your eyes closed while standing on a towel (to give your foot an unstable platform).

This is just an example of fitting exercise into your day. You can do a simple variation on the toothbrush exercise while shopping. When you are waiting on line, simply stand on one leg. Once you get the hang of that, you can progress by lightly twisting while standing on one leg.

An important time to fit in exercise is when sitting for prolonged periods. Sitting for prolonged periods can put significant strain on the disks in the lower back, especially if you sit with poor posture (which many of us do). It's important to reverse the flexion of sitting periodically. Here are some approaches to reversing that flexion:

1. Stand up. The simplest is to simply stand up and walk for a few minutes. I advise that office workers should (if their bosses will allow it) print all documents to a printer on the other side of the office. This will force you to periodically stand up to walk to the printer.

2. Upward facing dog. If you are in an environment that provides sufficient modesty (e.g., at home, or in an office with a closed door), a great exercise to reverse the flexed position of sitting is the upward facing dog exercise, common in the sun salutations from yoga. An example of this exercise is shown at the following link (http://www.yogajournal.com/poses/474). The upward facing dog exercise is very similar to the Prone Press-Up, which is one of the corner stones of McKenzie Physical Therapy, a form of physical therapy that is particularly effective for low back pain. I recommend doing this exercise at least every 30 minutes if your work environment allows to reverse the flexion of prolonged sitting.

3. Standing back extensions. Another great exercise, which may be able to do logistically, is to stand up and extend your back. It may be easier to place both of your hands in the small of your back as you arch backwards.

4. Push-ups. Another good exercise. In addition to strengthening the chest and shoulder muscles, the posture of the push up (a plank position) requires tightening your innermost abdominal muscles (the transversus abdominus), which is important for maintaining balance across your lower back. Push-ups are great for fitting in periodic exercise throughout your day- crank out a quick 5-10 pushups when you get out of your chair, during commercials while watching TV, or just before sitting to eat dinner.

I hope these exercises serve as useful examples for how you can fit small bits of exercise throughout your day.

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